The Drug-Induced Respiratory Disease Website and App

Radiation therapy (early effects)

To the chest. Changes are usually ipsilateral to the irradiated side except in acute radiation pneumoniitis and in radiation-elicited BOOP

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I - Interstitial/parenchymal lung disease

I.a

Pneumonitis (ILD), acute and/or severe (may produce the ARDS pattern)

I.b

Pneumonitis (interstitial lung disease/ILD)

I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

I.d

Organizing pneumonia pattern (an area or areas of consolidation on imaging)

I.v

Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence

I.y

Progression, acceleration or exacerbation of preexisting ILD/fibrosis

I.ab

Radiation-induced lung injury (RILI)

I.ac

Acute radiation pneumonitis

II - Pulmonary edema - Acute lung injury - ARDS

II.b

ARDS - Acute lung injury

V - Pleural and/or pericardial involvement

V.a

Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

V.h

Chylothorax

VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement

VIII.c

Upper airway obstruction other than angioedema or hematoma

IX - Neuromuscular / CNS involvement - Disordered breathing (during sleep)

IX.h

Dyspnea, unexplained otherwise

XI - Miscellaneous

XI.w

Cavitation/necrosis of lung tumor or metastases

XII - Cardiovascular involvement / toxicity

XII.k

Constrictive pericarditis - Pericardial thickening

XV - Pathology

XV.a

Path: NSIP-cellular pattern (see also Ia, Ib)

XV.b

Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)

XV.c

Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)

XV.d

Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also pattern If)

XV.f

Path: Diffuse alveolar damage (DAD-pattern) (see also IL)

XV.h

Path: NSIP-fibrotic pattern

XV.i

Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign)

XVI - Imaging

XVI.ab

Imaging: Cavitating/cavitary lung nodule, mass or nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)

XVI.bl

Imaging: An area or areas of avid tracer uptake in the lung/chest on 18F-PET scan

XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA

XIX.a

BAL: An excess proportion of lymphocytes

XIX.c

BAL: An excess proportion of eosinophils